Supplements and Nortriptyline.
Nortriptyline, sold under the brand names Allegron, Pamelor, is an antidepressant: depending on the agent, it acts on serotonin, noradrenaline, or both.
Nortriptyline sits in the BNF "other antidepressants" group. The group includes the SNRIs (venlafaxine, duloxetine), the atypicals (mirtazapine, agomelatine, vortioxetine), and the older tetracyclics. The clinical class matters more than the BNF group, because the supplement profile differs sharply across it. SNRIs share the SSRI serotonergic concerns. Mirtazapine sits closer to the sedating, appetite-stimulating profile. Agomelatine is heavily liver-metabolised with mandatory LFT monitoring. Where these antidepressants share a supplement surface, it is St John's Wort (hard exclude across the class), 5-HTP (hard exclude on serotonergic grounds), rhodiola, and any supplement with significant sedating or activating effect depending on the agent. Discontinuation profiles differ too. Venlafaxine has the heaviest withdrawal syndrome of common antidepressants. Agomelatine probably the lightest.
Below are the 5 documented pairs we have explicitly assessed against Nortriptyline in the Distil database: 1 red and 4 amber. The pairs cluster around 3 mechanisms: Additive serotonergic activity, Cholinergic vs anticholinergic (opposing), and CYP induction. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 13 September 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive serotonergic activity
Red Does 5-HTP interact with Nortriptyline?
5-HTP is turned into serotonin in the body, and nortriptyline is a tricyclic antidepressant with a weaker but real effect on serotonin, so taking the two together can cause serotonin syndrome (agitation, sweating, tremor, a racing heart, confusion). Do not take 5-HTP with nortriptyline; if you already take both, tell the prescriber who manages your nortriptyline, and do not stop nortriptyline on your own.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does L-Tryptophan interact with Nortriptyline?
Tryptophan is the building block your body uses to make serotonin, while nortriptyline works mainly on noradrenaline and has only weak serotonin activity. Any added serotonin effect is likely to be small, but it is worth mentioning the tryptophan to your GP and watching for restlessness, sweating, or shivering if your dose has recently changed.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Saffron Extract interact with Nortriptyline?
Saffron has its own mild antidepressant effect that appears to act on serotonin, and nortriptyline acts on serotonin and noradrenaline too. Taking them together may add up. Most people tolerate it, but discuss it with your GP before stacking, especially if your dose has recently changed.
Evidence: Limited human data, from small studies or case reports.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Cholinergic vs anticholinergic (opposing)
Amber Does Huperzine A interact with Nortriptyline?
Huperzine A raises acetylcholine, while nortriptyline has an anticholinergic effect that blocks it. The two can work against each other, and nortriptyline may blunt any benefit from huperzine A. It is worth mentioning the huperzine A to your prescriber.
Evidence: No direct study of this exact combination yet; the caution rests on a plausible mechanism or on reports involving a related medicine.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
CYP induction
Amber Does St John's Wort interact with Nortriptyline?
St John's Wort can speed up how the body clears nortriptyline, lowering its level in your blood so it works less well for low mood or pain. In a study, blood levels of nortriptyline dropped by about 40 percent. If you take nortriptyline, mention St John's Wort to your GP or pharmacist rather than starting it on your own, and watch for symptoms returning.
Evidence: Supported by human study data.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
No affiliates. No commission. We earn nothing on what you buy.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
£49 founder pricing while Distil is new, or returning within 6 months · £79 standard.
Something missing?
If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.